Pakistan doctors beaten by police as they despair of 'untreatable' pandemic

Doctors in Pakistan have warned of “deplorable” conditions on the frontlines of the country’s coronavirus outbreak, describing the pandemic as untreatable in one region and accusing police of brutally suppressing protests over working conditions.

One doctor who took part in a sit-in on Monday to protest against a lack of personal protective equipment said he had been “beaten and humiliated” by police.

“In the beginning, I thought, ‘How could police use violence against the frontline fighters of Covid-19 when some days ago the same officers had saluted us for leading during the pandemic?’” said Amanullah, speaking from the police station where he was being held in Quetta, in the Balochistan region.

“But we were wrong. Sticks and butts of AK-47 rifles rained down on us. We were dragged through the street and thrown into trucks.” He and about 60 other doctors were held in police detention overnight and only released at midnight on Tuesday.

In the hospital where Amanullah works in the emergency ward, 16 doctors, including the head of the cardio department, have already been diagnosed with Covid-19. “We can’t say that how many patients they spread the disease to,” he added.

Many of the patients who he and other emergency ward doctors had treated for non-coronavirus issues have since tested positive for the virus.

However, doctors in the state-run hospital still have not been provided with PPE and in facilities that have not been designated as Covid-19 hospitals there are no isolation wards for doctors who have been infected.

Shoppers waiting to buy groceries have their hands sanitised in Karachi.Photograph: Asif Hassan/AFP/Getty

Across the whole of Balochistan, which has become the focus of Pakistan’s coronavirus outbreak, there are just 19 ventilators. The country has reported 4,000 cases of coronavirus, but testing rates are low and doctors believe the real figure is much higher.

“There is a lot of psychological distress and trauma, as we have no idea how many patients we have infected or will be infecting,” said Amanullah. “That’s why we decided to march and demand PPE; not for ourselves, but to save the lives of many.”

Younas Elahi, a doctor working in a hospital in Quetta, said that for colleagues in the region who had not been given the necessary equipment, treating coronavirus patients was akin to suicide.

We are so vulnerable and it makes me cry when I see patients begging for help when doctors can’t even touch them

Dr Younas Elahi

“Doctors are killing themselves in hospitals by treating patients without PPE,” said Elahi. “They have no safe equipment. On the other hand, the government is unleashing violence against doctors.”

Without proper safety equipment, doctors have had no choice but to refuse to treat coronavirus patients, he said, describing the situation as “insane”. “We are so vulnerable and it makes me cry when I see patients begging for help when doctors can’t even touch them. The health facilities here are deplorable … I think this pandemic is untreatable in Balochistan.”

In one of the largest hospitals designated to deal with coronavirus, the Pakistan Institute of Medical Sciences in Islamabad, the capital, there are only 50 or so functioning ventilators. And two-thirds of Pakistan’s population live in rural communities with no access to hospitals equipped to deal with coronavirus patients, or sometimes to any medical facilities at all.

Dr Zafar Mirza, special assistant on health to the prime minister, Imran Khan, said the issue was not an equipment shortage, but “irrational use of PPEs”. “The federal government has supplied at least three times the requested quantities, but due to irrational use and leakages they did not reach the right people,” he said.

Since 2010, healthcare in Pakistan has been devolved to provincial governments, where there has been rampant mismanagement and underfunding, leading to wildly varying standards across the country.

The dysfunction in Pakistan’s coronavirus response also appears to go to the very top, played out in a public dispute between the federal government, provincial governments and the military over the decision whether or not to implement a full lockdown.

On 23 March, Khan declared that he would not implement a national lockdown because of the impact on Pakistan’s poorest. But just hours later, Murad Ali Shah, chief minister of Sindh province, announced a full 15-day lockdown in his state “to save the people of Sindh from this epidemic”. The military, who wield enormous amounts of power and influence in Pakistan, then stepped in and undermined Khan by adding their support for a full lockdown.

On Tuesday, the military took the unusual step of providing emergency supplies of medical equipment to hospitals in Quetta, a job that would usually fall within the remit of provincial and central government.

The apparent inconsistencies were defended by Mirza, who said that “central and provincial governments are almost on the same page. We are a federation and there can always be differences of approach.”

Khan has also been criticised for underplaying the impact of the virus, which doctors say is resulting in incidents such as last Friday’s, when hundreds of thousands of people across Pakistan defied restrictions to attend prayers.

A doctor in Islamabad described Khan’s recent public remarks that coronavirus has a low mortality rate and was not dangerous to young or healthy people as “illogical and unsafe”.

“It is to scary to keep repeating this mantra to the public,” he said. “Imran Khan is not taking it seriously: that’s why the public and his supporters are not taking it seriously too.”